• Accumulation of squamous epithelium and keratin debris that usually involves the middle ear and mastoid.
  • Although benign, it may enlarge and invade adjacent bone.
  • Often presents with a malodorous ear discharge with associated hearing loss.
  • Diagnosis is clinical based on history and otoscopic findings. CT scan provides lesion definition and extent.
  • Treatment is surgical removal. Adjunctive topical antimicrobial treatment may help reduce acute symptoms preoperatively.
  • Complications include recurrence, meningitis, facial palsy, and a labyrinthine fistula.

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